KANSER HASTALIĞI OLAN EBEVEYNLERİN ÇOCUKLARI: ETKİLER VE YAKLAŞIMLAR

Öz

Kanser tanısı konulan bireylerde görülebilen fiziksel, sosyal ve psikolojik sorunların yanı sıra diğer aile üyelerinde de aile dengesinin bozulması, rol kaybı ya da rol değişikliği nedeniyle hastalardan daha fazla duygusal ve davranışsal sorunlar ile karşılaşılmaktadır. Bu süreçte özellikle kanser olan ebeveynlerin çocukları duygusal ve davranışsal problemler açısından daha yüksek risk altındadır. Kanser hastalığı olan ebeveynin hastalık sürecinin ailenin günlük rutinlerini değiştirmesi, evdeki rollerin farklılık göstermesi, finansal sorunların yaşanması, her iki ebeveynin de fiziksel ve duygusal tükenmişlik yaşaması çocuklarda görülen duygusal ve davranışsal sorunların başlıca nedenlerindendir. Ebeveyninde kanser hastalığı olan çocuklarda anksiyete, depresyon, agresif davranışlar ya da somatik şikayetler gibi psikososyal etkiler ile ağlama, güvensizlik, arkadaş ilişkilerinde bozulma, ebeveynlerden uzaklaşma ya da aşırı ilgi gösterme ve okula konsantre olamama gibi bilişsel ve davranışsal etkiler görülebilir. Ayrıca günlük rutinlerin bozulması ve yaşanan duygusal semptomlar nedeniyle baş ağrısı, uykusuzluk, iştah kaybı gibi fiziksel sorunlar gelişebilir. Çocuğun bu süreçten etkilenmesi; çocuğun cinsiyeti, gelişim dönemi, ebeveynde var olan hastalığı algılayışı, ebeveyn ile çocuk arasındaki ilişki, aile işlevleri, kanserin evresi ve ebeveynin sağlık durumuna göre farklılaşmakla birlikte çocukların sosyal destek ihtiyacı artış göstermektedir. Ebeveynine kanser tanısı konulan çocukların kanserin etkilerini belirlemede, düşüncelerini ifade etmede ve dayanıklılığını artırmak için sosyal destek sağlamada yardım alması önemlidir. Literatürde ebeveyni kanser olan çocuklara yönelik girişimlerin oldukça sınırlı olduğu görülmektedir. Bu makalede konuya yönelik farkındalık sağlamak amacıyla kanser tanısı alan ebeveyne sahip çocukların olumsuz etkilenmelerini en aza indirebilecek girişimlerden bahsedilmektedir.

Anahtar Kelimeler

• Ebeveynlik
• Kanser
• Çocuk sağlığı
• Psikososyal girişimler

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Children Of Parents With Cancer: Impacts And Approaches

Öz

In addition to the physical, social, and psychological problems observed in individuals diagnosed with cancer, other family members also experience more emotional and behavioral issues than patients due to disruptions in family balance, role loss, or role changes. During this process, especially children of parents with cancer are at a higher risk of developing emotional and behavioral problems. The primary reasons for these issues in children include the alteration of daily routines within the family due to the parent's illness, changes in roles at home, financial difficulties, and both parents experiencing physical and emotional burnout. Children diagnosed with a parent with cancer may encounter psychosocial effects such as anxiety, depression, aggressive behaviors, or somatic complaints, as well as cognitive and behavioral effects such as crying, insecurity, deterioration in peer relationships, withdrawal from parents, or excessive attention and an inability to concentrate at school. Additionally, physical problems such as headaches, insomnia, and loss of appetite may develop due to disruptions in daily routines and emotional symptoms. The impact of a parent's cancer on the child varies according to the child's gender, developmental stage, perception of the parent's illness, the relationship between the parent and the child, family functions, the stage of cancer, and the health status of the parent. Throughout this process, children's need for social support increases. It is crucial for children to receive assistance in recognizing the impacts of cancer, expressing their thoughts, and obtaining social support to enhance their resilience following a parent's cancer diagnosis. The literature indicates that interventions for children with parents diagnosed with cancer are rather limited. This article aims to shed light on interventions that can mitigate the adverse effects on children with parents facing cancer, emphasizing the need for increased awareness on this subject.

Anahtar Kelimeler

• Parenting
• Cancer
• Child Health
• Psychosocial Interventions

Proje Numarası

yok

Kaynakça

1. Alexander, E., O'Connor, M., & Halkett, G. K. B. (2020, Nov). The perceived effect of parental cancer on children still living at home: According to oncology health professionals. Eur J Cancer Care (Engl), 29(6), e13321. https://doi.org/10.1111/ecc.13321
2. Alexander, E., O'Connor, M., Rees, C., & Halkett, G. (2019, Oct). A systematic review of the current interventions available to support children living with parental cancer. Patient Educ Couns, 102(10), 1812-1821. https://doi.org/10.1016/j.pec.2019.05.001
3. Arber, A., & Odelius, A. (2018). Experiences of Oncology and Palliative Care Nurses When Supporting Parents Who Have Cancer and Dependent Children. Cancer Nursing, 41(3), 248-254. https://doi.org/10.1097/ncc.0000000000000491
4. Bultmann, J. C., Beierlein, V., Romer, G., Moller, B., Koch, U., & Bergelt, C. (2014, Dec 1). Parental cancer: Health-related quality of life and current psychosocial support needs of cancer survivors and their children. Int J Cancer, 135(11), 2668-2677. https://doi.org/10.1002/ijc.28905
5. Chen, R., Sjolander, A., Valdimarsdottir, U., Varnum, C., Almqvist, C., Ye, W., Fall, K., Czene, K., & Fang, F. (2015, Feb). Parental cancer diagnosis and child mortality--a population-based cohort study in Sweden. Cancer Epidemiol, 39(1), 79-85. https://doi.org/10.1016/j.canep.2014.11.011
6. Cho, O. H., Yoo, Y. S., & Hwang, K. H. (2015, May). Comparison of parent-child communication patterns and parental role satisfaction among mothers with and without breast cancer. Appl Nurs Res, 28(2), 163-168. https://doi.org/10.1016/j.apnr.2014.09.005
7. Costas-Muniz, R. (2012, Feb). Hispanic adolescents coping with parental cancer. Support Care Cancer, 20(2), 413-417. https://doi.org/10.1007/s00520-011-1283-9
8. Ellis, S. J., Wakefield, C. E., Antill, G., Burns, M., & Patterson, P. (2017). Supporting children facing a parent's cancer diagnosis: a systematic review of children's psychosocial needs and existing interventions. European Journal of Cancer Care, 26(1), e12432. https://doi.org/https://doi.org/10.1111/ecc.12432

9. Hailey, C. E., Yopp, J. M., Deal, A. M., Mayer, D. K., Hanson, L. C., Grunfeld, G., Rosenstein, D. L., & Park, E. M. (2018, Jan). Communication with children about a parent's advanced cancer and measures of parental anxiety and depression: a cross-sectional mixed-methods study. Support Care Cancer, 26(1), 287-295. https://doi.org/10.1007/s00520-017-3847-9
10. Hauken, M. A., Senneseth, M., Dyregrov, A., & Dyregrov, K. (2018, Jan/Feb). Anxiety and the Quality of Life of Children Living With Parental Cancer. Cancer Nurs, 41(1), E19-E27. https://doi.org/10.1097/NCC.0000000000000467
11. Hauskov Graungaard, A., Hafting, M., Davidsen, A. S., & Lykke, K. (2021, Dec 28). How is my child doing - parental understanding of their children when a parent has cancer. J Psychosoc Oncol, 1-16. https://doi.org/10.1080/07347332.2021.2013386
12. Hoeg, B. L., Christensen, J., Banko, L., Frederiksen, K., Appel, C. W., Dalton, S. O., Dyregrov, A., Guldin, M. B., Jorgensen, S. E., Lytje, M., Boge, P., & Bidstrup, P. E. (2021, Jul 24). Psychotropic medication among children who experience parental death to cancer. Eur Child Adolesc Psychiatry. https://doi.org/10.1007/s00787-021-01846-y
13. Inhestern, L., Haller, A. C., Wlodarczyk, O., & Bergelt, C. (2016). Psychosocial Interventions for Families with Parental Cancer and Barriers and Facilitators to Implementation and Use - A Systematic Review. PLoS One, 11(6), e0156967. https://doi.org/10.1371/journal.pone.0156967
14. Inhestern, L., Johannsen, L. M., & Bergelt, C. (2021). Families Affected by Parental Cancer: Quality of Life, Impact on Children and Psychosocial Care Needs. Front Psychiatry, 12, 765327. https://doi.org/10.3389/fpsyt.2021.765327
15. Inoue, I., Higashi, T., Iwamoto, M., Heiney, S. P., Tamaki, T., Osawa, K., Inoue, M., Shiraishi, K., Kojima, R., & Matoba, M. (2015, Dec). A national profile of the impact of parental cancer on their children in Japan. Cancer Epidemiol, 39(6), 838-841. https://doi.org/10.1016/j.canep.2015.10.005
16. International Agency For Research on Cancer. (2020). Estimated number of prevalent cases (5-year) in 2020, all cancers, both sexes, ages 25-49. Retrieved 20.02.2022 from https://gco.iarc.fr/today/online-analysis-pie?v=2020&mode=population&mode_population=countries&population=900&populations=900&key=total&sex=0&cancer=39&type=2&statistic=5&prevalence=1&population_group=4&ages_group%5B%5D=5&ages_group%5B%5D=9&nb_items=7&group_cancer=1&include_nmsc=0&include_nmsc_other=1&population_group_list=4,51,31,48,50,64,96,116,160,275,268,356,360,364,368,376,392,400,398,408,410,414,417,418,422,458,462,496,104,524,512,586,608,634,682,702,144,760,762,764,626,792,795,784,860,704,887&half_pie=0&donut=0&population_group_globocan_id=935
17. Jantzer, V., Gross, J., Stute, F., Parzer, P., Brunner, R., Willig, K., Schuller-Roma, B., Keller, M., Herzog, W., Romer, G., & Resch, F. (2013, Nov). Risk behaviors and externalizing behaviors in adolescents dealing with parental cancer--a controlled longitudinal study. Psychooncology, 22(11), 2611-2616. https://doi.org/10.1002/pon.3327
18. Joëls, M., & Baram, T. Z. (2009, 2009/06/01). The neuro-symphony of stress. Nature Reviews Neuroscience, 10(6), 459-466. https://doi.org/10.1038/nrn2632
19. Joergensen, A. C., Kjaer Urhoj, S., & Nybo Andersen, A. M. (2018, Nov). Primary school achievement and socioeconomic attainment in individuals affected by parental cancer in childhood or adolescence: a Danish nationwide register-based study. J Epidemiol Community Health, 72(11), 982-989. https://doi.org/10.1136/jech-2018-210472
20. Kazlauskaite, V., & Fife, S. T. (2021). Adolescent Experience With Parental Cancer and Involvement With Medical Professionals: A Heuristic Phenomenological Inquiry. Journal of Adolescent Research, 36(4), 371-397. https://doi.org/10.1177/0743558420985446
21. Krattenmacher, T., Kuhne, F., Ernst, J., Bergelt, C., Romer, G., & Moller, B. (2012, May). Parental cancer: factors associated with children's psychosocial adjustment--a systematic review. J Psychosom Res, 72(5), 344-356. https://doi.org/10.1016/j.jpsychores.2012.01.011
22. Landi, G., Duzen, A., Patterson, P., McDonald, F. E. J., Crocetti, E., Grandi, S., & Tossani, E. (2022, Jan). Illness unpredictability and psychosocial adjustment of adolescent and young adults impacted by parental cancer: the mediating role of unmet needs. Support Care Cancer, 30(1), 145-155. https://doi.org/10.1007/s00520-021-06379-3
23. Marin-Chollom, A. M., & Revenson, T. A. (2022). Cultural values as a resilience resource for Latino/a adolescents and young adults coping with parental cancer. J Psychosoc Oncol, 40(1), 26-44. https://doi.org/10.1080/07347332.2021.1881197
24. Martini, A., Morris, J. N., Jackson, H. M., & Ohan, J. L. (2019, Apr). The impact of parental cancer on preadolescent children (0-11 years) in Western Australia: a longitudinal population study. Support Care Cancer, 27(4), 1229-1236. https://doi.org/10.1007/s00520-018-4480-y
25. Moore, C. W., Rauch, P. K., Baer, L., Pirl, W. F., & Muriel, A. C. (2015). Parenting changes in adults with cancer. Cancer, 121(19), 3551-3557. https://doi.org/https://doi.org/10.1002/cncr.29525
26. Morris, J. N., Martini, A., & Preen, D. (2016, Jul). The well-being of children impacted by a parent with cancer: an integrative review. Support Care Cancer, 24(7), 3235-3251. https://doi.org/10.1007/s00520-016-3214-2
27. Morris, J. N., Turnbull, D., Martini, A., Preen, D., & Zajac, I. (2020, Jan-Feb). Coping and its relationship to post-traumatic growth, emotion, and resilience among adolescents and young adults impacted by parental cancer. J Psychosoc Oncol, 38(1), 73-88. https://doi.org/10.1080/07347332.2019.1637384
28. Niemela, M., Paananen, R., Hakko, H., Merikukka, M., Gissler, M., & Rasanen, S. (2012, Nov 1). The prevalence of children affected by parental cancer and their use of specialized psychiatric services: the 1987 Finnish Birth Cohort study. Int J Cancer, 131(9), 2117-2125. https://doi.org/10.1002/ijc.27466
29. O'Neill, C., O'Neill, C. S., & Semple, C. (2020, Jun). Children Navigating Parental Cancer: Outcomes of a Psychosocial Intervention. Compr Child Adolesc Nurs, 43(2), 111-127. https://doi.org/10.1080/24694193.2019.1582727
30. Patterson, P., McDonald, F. E. J., White, K. J., Walczak, A., & Butow, P. N. (2017, Sep). Levels of unmet needs and distress amongst adolescents and young adults (AYAs) impacted by familial cancer. Psychooncology, 26(9), 1285-1292. https://doi.org/10.1002/pon.4421
31. Rodriguez, L. (2019, Feb). Selective sharing: The impact of patterns of communication in young people experiencing maternal cancer. Cancer Rep (Hoboken), 2(1), e1138. https://doi.org/10.1002/cnr2.1138
32. Semple, C. J., & McCaughan, E. (2013, Mar). Family life when a parent is diagnosed with cancer: impact of a psychosocial intervention for young children. Eur J Cancer Care (Engl), 22(2), 219-231. https://doi.org/10.1111/ecc.12018
33. Shah, B. K., Armaly, J., & Swieter, E. (2017, Aug). Impact of Parental Cancer on Children. Anticancer Res, 37(8), 4025-4028.https://doi.org/10.21873/anticanres.11787
34. Shands, M. E., & Lewis, F. M. (2021, Aug). Parents With Advanced Cancer: Worries About Their Children's Unspoken Concerns. Am J Hosp Palliat Care, 38(8), 920-926. https://doi.org/10.1177/1049909120969120
35. Stafford, L., Sinclair, M., Rauch, P., Turner, J., Mann, G. B., Newman, L., Wakefield, C. E., Gilham, L., Mason, K., Cannell, J., Little, R., & Schofield, P. (2021, Jul). Feasibility of Enhancing Parenting in Cancer, a psychoeducational intervention for communicating with children about parental cancer. Psychooncology, 30(7), 1172-1177. https://doi.org/10.1002/pon.5655
36. Syse, A., Aas, G. B., & Loge, J. H. (2012). Children and young adults with parents with cancer: a population-based study. Clin Epidemiol, 4, 41-52. https://doi.org/10.2147/CLEP.S28984
37. Visser, A., Huizinga, G. A., van der Graaf, W. T., Hoekstra, H. J., & Hoekstra-Weebers, J. E. (2004, Dec). The impact of parental cancer on children and the family: a review of the literature. Cancer Treat Rev, 30(8), 683-694. https://doi.org/10.1016/j.ctrv.2004.06.001
38. Weaver, K. E., Rowland, J. H., Alfano, C. M., & McNeel, T. S. (2010). Parental cancer and the family. Cancer, 116(18), 4395-4401. https://doi.org/https://doi.org/10.1002/cncr.25368